Medicare Compliance & Reimbursement

Question: Is there a new code to show Medicare that we are e-prescribing in 2014? We are concerned if we don’t use a code, they may be under the impression that we are not e-prescribing. We don’t want to end up being penalized because we didn’t attach a code to our claims, like we did with G8553. What should you do?

Answer: In recent years, you could report G8553 (Prescription[s] generated and transmitted via a qualified ERX system) as documentation of electronic prescriptions your physician wrote. However, 2014 is the last year to receive an incentive for e-prescribing, if you qualified for the incentive from previous years’ reporting. You no longer have to report the G8553 – plus, G8553 expired on Dec. 31, 2013.

You don’t have a replacement for G8553 because the sole purpose of the code was for tracking the electronic prescription incentive/penalty program. Since that is now set based on whether a provider got his required number of codes in during the reporting period or not, there really isn’t a need for the code.